Provider Demographics
NPI:1164448536
Name:SOUTH CAROLINA CARDIOLOGY CONSULTANTS, PA
Entity Type:Organization
Organization Name:SOUTH CAROLINA CARDIOLOGY CONSULTANTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-886-9300
Mailing Address - Street 1:704 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-2637
Mailing Address - Country:US
Mailing Address - Phone:864-886-9300
Mailing Address - Fax:864-886-9399
Practice Address - Street 1:704 N PINE ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-2637
Practice Address - Country:US
Practice Address - Phone:864-886-9300
Practice Address - Fax:864-886-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6229Medicare ID - Type Unspecified